JOURNAL OF CLINICAL SURGERY ›› 2019, Vol. 27 ›› Issue (12): 1024-1027.doi: 10.3969/j.issn.1005-6483.2019.12.004

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The risk factors and measures of postoperative intestinal adhesions in patients with laparoscopic cholecystectomy

  

  1. Department of Liver and Gallbladder surgery,the Second People's Hospital of Liaocheng,Shandong,Liaocheng 252600,China
  • Online:2019-12-20 Published:2019-12-20

Abstract: Objective To investigate the risk factors study and measures of postoperative intestinal adhesion in patients with laparoscopic cholecystectomy.Methods A total of 224 patients who treatment by LC in our hospital between April 2015 and April 2018 were selected as the study subjects,and occurrence of intestinal adhesions in all subjects after LC postoperation were recorded.According to the occurrence of intestinal adhesions that the patients with after postoperation were divided as intestinal adhesions group(n=45)and without intestinal adhesions group(n=179),and useing analyzed by relevant statistical analysis software the time of anal exhaust,sex,residual infection of abdominal cavity,BMI,patients's experience in LC operation,age,indwelling drainage tube,etc were conducted by monofactor analysis,and logistic regression analysis was conducted on the meaningful indexes of univariate analysis.The 45 cases of intestinal adhesions after LC postoperation were divided into conservative treatment group(n=25)and laparoscopic enterolysis treatment group(n=20)according to the different treatment methods,and the therapeutic effect of intestinal adhesion after LC was compared between the two groups,and effective prevention and treatment measures were summarized.Results After LC,intestinal adhesion occurred in 45 cases,but not in 179 cases.Patients with intestinal adhesion were randomly divided into conservative treatment group(25 cases)and laparoscopic intestinal adhesion release(20 cases).Group of intestinal adhesion after LC postoperation that after postoperation Indwelling drain tube,abdominal residual infection,diabetes mellitus,anal exhaust time >24h,and the proportion of LC operation ≤50 cases was significantly higher than that of no postoperative intestinal adhesion group,and there was statistical difference(P<0.05);diabetes mellitus,abdominal residual infection after postoperation,postoperative indwelling drainage tube,LC operation of patients ≤50 cases were independent risk factors of intestinal adhesion after LC(P<0.05);the total effective rate of laparoscopic enterolysis group was significantly higher than that of conservative treatment group,and there was statistical difference(P<0.05).Conclusion Complicated with diabetes,postoperative abdominal residual infection,postoperative indwelling drainage tube and performer LC operation≤50 cases,which are risk factors for postoperative intestinal adhesion in patients with laparoscopic cholecystectomy.

Key words: laparoscopic cholecystectomy, intestinal adhesion, risk factors, treatment measures

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